In the recent years, with the entrance of new players to the anti-fraud technology market, such technologies have proliferated and the data resources especially those that are extracted from public domains have tremendously augmented. The increasing competition and the expansion of outsourced services have decreased the expenditures in some sectors hence leading to the development of detection and analysis tools for the insurers. This has even been witnessed among SME’s.
Given the significance of this issue, IRC has accomplished and released a research report titled “The Status of Technology and the Insurance Fraud Detection Strategies: The Use Cases among Insurers, Standards and Solutions”, according to PRIAO Report, IRC. The report is prepared by the Algorithm Design and Machine Learning Desk of IRC by the collaboration of its director, Dr. Farbod Khanizadeh, also the Director of Property and Casualty Insurance Research Group and Mr. Mahdi Goharpad, Master’s in Business Management.
The research report deals with the following issues during 2014-2021: the status of fraud and technology, fraud detection tools and strategies, the space where systems are produced and maintained, data resources, the percentage of system references, anti-fraud technology benefits, challenges, operational fields, the success of anti-fraud systems, the changes in the amount of frauds, budgets, fields, and the types of the future investments. Later in the rerpot, some of the rules and regulations and insurers’ and experts’ views in relation to prevention and detection of frauds are reviewed. Finally, some solutions and measures that can be used by the insurance companies in order to detect and prevent frauds are provided.
According to the results of the study, since the onset of the COVID-19 pandemic, suspicious activities have been increased and the fraudulent methods have been increasingly more complicated. Accordingly, leaders who fight against fraud must take difficult decisions when it comes to increasing budget or sustain the investments in known and reliable tools such as automatic supervision, developing newer anti-fraud solutions and techniques such as blockchain and identity recognition technologies.
Fraud detection systems and anti-fraud technologies are not simply able to recognize and confirm suspicious cases and the presence of experienced officers and experts are necessary to review the identified cases for any final decision.
Those interested to access and download the Persian full text of the aforementioned research report, please take a visit to https://www.irc.ac.ir/fa-IR/Irc/4946/Articles/view/14643/1577.